未经证实:原发性肝细胞癌通常并发肝炎和肝硬化。一些患者出现不同程度的脾肿大,肝硬化加重导致的脾功能亢进和肝功能减退,在一定程度上干扰肿瘤的治疗,甚至影响患者的预后。在这项研究中,我们前瞻性评估了CalliSpheres®微球同时经导管动脉化疗栓塞术(CSM-TACE)和部分脾栓塞术(PSE)治疗肝细胞癌(HCC)合并脾功能亢进的疗效和安全性.
UNASSIGNED:选择90例连续接受CSM-TACE的肝癌脾功能亢进患者:CSM-TACE+PSE组32例,CSM-TACE组58例。外周血细胞计数(白细胞,血小板(PLT),肝功能和红细胞(RBC),CSM-TACE和/或PSE相关并发症,比较CSM-TACE术后1个月的肿瘤控制率。观察两组患者的生存时间和预后因素。
未经评估:在CSM-TACE之前,性别没有显著差异,年龄,Child-Pugh年级,肿瘤大小,甲胎蛋白(AFP)在两组之间。在CSM-TACE之后,CSM-TACE+PSE组PLT和白细胞(WBC)计数明显高于CSM-TACE组(P<0.05)。RBC治疗前后比较差异无统计学意义(P>0.05)。在CSM-TACE组中,WBC没有显着差异,PLT,治疗前后RBC的变化(P>0.05)。两组治疗后1个月肝功能无明显差异。CSM-TACE+PSE组胆碱酯酶(CHE)水平在CSM-TACE+PSE后明显高于CSM-TACE+PSE前,且高于CSM-TACE组(P<0.05)。然而,CSM-TACE组CHE水平在CSM-TACE后1个月恢复至术前水平.CSM-TACE+PSE组的客观缓解率(ORR)和中位总生存期(OS)均高于CSM-TACE组(P<0.05)。两组不良反应均为发热,腹痛,胃部不适,恶心,呕吐,无严重并发症发生。实验组腹痛、发热程度低于对照组(P>0.05)。
UNASSIGNED:使用国产栓塞颗粒同时进行CSM-TACE和PSE治疗肝癌脾功能亢进具有良好的安全性和有效性,PSE相关不良事件发生率低,有利于提高肝功能储备,并且可以进一步提高中位数OS。
UNASSIGNED: Primary hepatocellular carcinoma is often complicated with hepatitis and liver cirrhosis. Some patients develop different degrees of splenomegaly, hypersplenism and hypohepatia due to the aggravation of liver cirrhosis, which to some extent interfere with the treatment of tumors and even affect the prognosis of patients. In this study, we prospectively evaluate the efficacy and safety of simultaneous CalliSpheres® microspheres transcatheter arterial chemoembolization (CSM-TACE) and partial splenic embolization (PSE) using 8spheres® for hepatocellular carcinoma (HCC) with hypersplenism.
UNASSIGNED: Ninety consecutive HCC patients with hypersplenism who underwent CSM-TACE were selected: 32 patients in CSM-TACE+PSE group, and 58 patients in CSM-TACE group. The peripheral blood cell counts (leukocyte, platelet (PLT), liver function and red blood cell (RBC)), CSM-TACE and/or PSE related complications, and the tumor control rate at 1 month after CSM-TACE were compared. The survival time and prognostic factors were also observed.
UNASSIGNED: Before CSM-TACE, there were no significant differences in sex, age, Child-Pugh grade, tumor size, and alpha-fetoprotein (AFP) between the two groups. After CSM-TACE, the PLT and white blood cell (WBC) counts in CSM-TACE+PSE group were significantly higher than those in the CSM-TACE group (P<0.05). There were no significant differences in RBC before and after treatment (P > 0.05). In the CSM-TACE group, there were no significant differences in WBC, PLT, and RBC before and after treatment (P > 0.05). There was no significant difference in liver function at 1 month after treatment between the two groups. The cholinesterase (CHE) level in the CSM-TACE+PSE group after CSM-TACE+PSE was obviously higher than that before CSM-TACE+PSE and higher than that in the CSM-TACE group (P<0.05). However, the level of CHE returned to the preoperative level 1 month after CSM-TACE in the CSM-TACE group. The objective response rate (ORR) and median overall survival (OS) in the CSM-TACE+PSE group were higher than those in the CSM-TACE group (P<0.05). The adverse reactions of the two groups were fever, abdominal pain, stomach discomfort, nausea, and vomiting, and no serious complications occurred. The degree of abdominal pain and fever in the experimental group was lower than that in the control group (P > 0.05).
UNASSIGNED: Simultaneous CSM-TACE and PSE using domestic embolization particles for HCC with hypersplenism have good safety and efficacy and has a low incidence of PSE-related adverse events, it is conducive to improving liver function reserve, and can further improve the median OS.